PB2648: THE RELATIONSHIP BETWEEN BALANCE CONFIDENCE, KINESIOPHOBIA AND LEG MUSCLE STRENGTH AMONG ADULT HEMOPHILIA PATIENTS
Authors: Sercan Onal Aykar, Zuhal Demirci, Fahri Sahin
Journal: HemaSphere (2023)

Topic: 33. Bleeding disorders (congenital and acquired) Background: Despite developing treatment options, adult patients with hemophilia still face musculoskeletal problems such as balance problems, muscle weakness and prorioceptive loss. These problems also lead to decreased physical activity and inactivity over time. Aims: The purpose of this study was to examine the association between balance confidence, kinesiophobia and leg muscle strength in adult patients with hemophilia. Methods: Patients with hemophilia A or B aged between 18-60 years were recruited from the Ege Adult Haemophilia and Thrombosis Center to participate in the study. The lower extremity muscle strength of the participants was evaluated with a handheld dynamometer. Tampa Scale of Kinesiophobia(TSK) was used to evaluate kinesiophobia and Activity-specific Balance Confidence Scale(ABC) was used for balance confidence evaluation. Correlations were calculated between all testing variables using Spearman correlation coefficients, and p < 0.05 was considered statistically significant. Results: A total of seventeen patiens; 10 with hemophilia A and 7 with hemophilia B (mean age = 37.59 ± 14.3 years, mean BMI = 24.56 ± 3.87 kg/m2) participated in this study. Seven had moderate and 10 had severe hemophilia No significant correlations were found between kinesiophobia and any of the strength measures (p>0.05). However, significant correlations were found between balance confidence and both hamstring and ankle dorsiflexors’ strength (p<0.05*). Summary/Conclusion: In patients with high hamstring and ankle dorsiflexors’ muscle strength, it will be easier to use the ankle strategy to control the forward and backward postural oscillations at low speeds and help to maintain balance. Therefore, it is normal for these people to have high balance confidence. However, this result is limited by the small number of subjects in this study and requires further investigation. Table 1. Correlations between each measured variable of kinesiophobia, balance confidence and leg muscle strength - TSK ABC Quad. Strength- R(Newton) Quad. Strength- L(Newton) Hams. Strength-R (Newton) Hams. Strength-L (Newton) DF Strength-R (Newton) DF Strength-L (Newton) PF Strength- R (Newton) PF Strength- L (Newton) TSK . 0,426 0,383 0,896 0,200 0,253 0,438 0,506 1,000 0,503 ABC 0,426 . 0,193 0,230 0,013* 0,003* 0,013* 0,019* 0,337 0,285 Quad. Strength- R (Newton) 0,383 0,193 . 0,003* 0,002* 0,001* 0,043* 0,016* 0,119 0,000* Quad. Strength- L (Newton) 0,896 0,230 0,003* . 0,016* 0,003* 0,013* 0,036* 0,058 0,055 Hams. Strength- R (Newton) 0,200 0,013* 0,002* 0,016* . 0,000* 0,008* 0,008* 0,001* 0,000* Hams. Strength- L (Newton) 0,253 0,003* 0,001* 0,003* 0,000* . 0,000* 0,000* 0,002* 0,000* DF Strength-R (Newton) 0,438 0,013* 0,043* 0,013* 0,008* 0,000* . 0,000* 0,004* 0,003* DF Strength-L (Newton) 0,506 0,019* 0,016* 0,036* 0,008* 0,000* 0,000* . 0,010* 0,002* PF Strength-R (Newton) 1,000 0,337 0,119 0,058 0,001* 0,002* 0,004* 0,010* . 0,001* PF Strength-L (Newton) 0,503 0,285 0,000* 0,055 0,000* 0,000* 0,003* 0,002* 0,001* . Spearman correlation; Significant correlation: p<0.05TSK: Tampa Scale of Kinesiophobia; ABC: Activity-specific Balance Confidence Scale; DF: Dorsiflexors; PF: Plantarflexors; Quad: Quadriceps; Hams: Hamstring; R: Right; L: Left Keywords: Hemophilia B, Hemophilia A, Hemophilia, Muscle